Rupture uterus: a retrospective analytical study

Shetal S. Prajapati; Kamal D. Goswami; Kavita M. Dudharejia; Avani N. Kannar; Prakash H. Parmar

doi:10.18203/2320-1770.ijrcog20180452

Authors

Shetal S. Prajapati Department of Obstetrics and Gynecology, PDU Medical College, Rajkot, Gujarat, India
Kamal D. Goswami Department of Obstetrics and Gynecology, PDU Medical College, Rajkot, Gujarat, India
Kavita M. Dudharejia Department of Obstetrics and Gynecology, PDU Medical College, Rajkot, Gujarat, India
Avani N. Kannar Department of Obstetrics and Gynecology, PDU Medical College, Rajkot, Gujarat, India
Prakash H. Parmar Department of Obstetrics and Gynecology, PDU Medical College, Rajkot, Gujarat, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20180452

Keywords:

Hysterectomy, Maternal morbidity and mortality, Obstructed labor, Rupture uterus

Abstract

Background: Over 500,000 women die each year due to complications of pregnancy and childbirth, a number that has remained relatively unchanged since 1990, when the first global estimates of the burden of maternal mortality were developed (WHO 2005). Objective of present study was to find out risk factors, management, related complications and associated maternal morbidity and mortality with rupture uterus.

Methods: A retrospective analytical study was performed at Department of Obstetrics and Gynecology, PDU Medical College, Rajkot, Gujarat, India over a period of 3 years during 2014-2016. Evaluation of maternal age, parity, SE status, booking status, obstetric risk factors, duration of hospital stay, causes of rupture uterus, Management, intra-op and post-operative complications, maternal morbidity and mortality was done.

Results: Total 29 cases of rupture uterus were found during study period. Most of them belong to age group of 21-30 (77.17%), Primipara (41.3%), Lower socioeconomic status (86.2%) and unbooked (65.52%) cases. Most common cause of rupture uterus was prolonged obstructed labor (51.72%) while scarred uterus (41.73%), transverse lie (3.44%) and injudicious use of oxytocin (3.44%) were others. In 16 cases obstetric Hysterectomy (55.17%) was performed while in 13 cases repair (44.82%) was done. We have found 2 cases of maternal death (6.89%) while study period with rupture uterus.

Conclusions: Present retrospective analytical study has concluded that rupture uterus is a life threatening complication. Proper antenatal and intrapartum care, identification of high risk factors, promotion of skilled attendance at birth and institutional delivery are key factors in reduction and early diagnosis.

Metrics

Metrics Loading ...

References

Jennifer B, Ndola P, Jill D, Martine H. proposal for the inclusion of misoprostol in the WHO model list of essential medicines; 17th Expert Committee on the Selection and Use of Essential Medicines Geneva. 2009:3-5.

Walsh CA, Baxi LV. Rupture of the primigravid uterus: A review of literature. Obstet Gynaecol Surv. 2007;62:327-34.

Bhaskar Rao K. Obstructed labor. In: Obstetrics and Gynecology for Postgraduates, Vol 1. 1st edn, Ratnam SS, Bhasker Rao K, Arulkumaran S (Eds.). Madras: Orient Longman,1992:130-2.

Ofir K, Sheiner E, Levy A, Katz M, Mazor M. Uterine rupture: risk factors and pregnancy outcome. Am J Obstet Gynecol. 2003 Oct;189(4):1042-6.

Gardeil F, Daly S, Turner MJ. Uterine rupture in pregnancy reviewed. Eur J Obstet Gynecol Reprod Biol. 1994;56:107-10.

Smith GC, Pell JP, Pasupathy D, et al. Factors predisposing to perinatal death related to uterine rupture during attempted vaginal birth after caesarean section: retrospective cohort study. BMJ. 2004;329:375.

Malik HS. Frequency, predisposing factors and fetomaternal outcome in uterine rupture. J Coll Physicians Surg Pak. 2006;16:472-5.

Rana S. Obstetrics trauma. In: Obstetrics and Perinatal Care for Developing Countries, 1st edn. Pakistan: SAF Publications;1998:1308-15.

Donald I. Maternal injuries. In: Practical Obstetrics Problems, 5th edn. Hong Kong: PG Publishing (Pvt.) Ltd;1983:795-803.

Ames RPM. Rupture of uterus. Am J Obstet Gynecol. 1981;14:361-95.

Miller DA, Diaz FG, Paul RH. Rupture of unscarred uterus. Am J Obstet Gynecol. 1996;174:345.

Miller DA, Goodwin TM, Gherman RB, Paul RH. Intrapartum rupture of the unscarred uterus. Obstet Gynecol. 1997 May;89(5):671-3.

Fedorkow DM, Nimrod CA, Taylor PJ. Rupture uterus in pregnancy: a Canadian hospital’s experience. CMAJ. 1987;137(1):27-9.

Landon MB, Hauth JC, Leveno KJ, Spong CY, Leindecker S, Varner MW, et al. Maternal and perinatal outcomes associated with a trial of labor after prior cesarean delivery. N Engl J Med. 2004;351(25):2581-9.

Kidantou HL, Mwampagatwa I, Van Roosmalen J. Uterine rupture: a retrospective analysis of causes, complications and management outcomes at Muhimbili National Hospital in Dares Salaam, Tanzania. Tanzan J Health Res. 2012 Jul;14(3):220-5.

Lavender T, Hart A, Smyth RM. Effect of partograph use on outcomes of women in spontaneous labour at term. Cochrane Database Syst Rev 2008;8(4):CD005461.

Lavender T, Lugina H, Smith H. The partograph: a life saving tool for African midwives. Trop Doct. 2007;37(3):191-2.

Mathews M: The partograph for prevention of obstructed labour. Clin Obstet Gynaecol. 2009;52(2):256-69.

Ozdemir I, Yucel N, Yucel O. Rupture of the pregnant uterus: a 9-year review. Arch Gynecol Obstet. 2005 Sep;272(3):229-31.